老年血液透析病人动静脉内瘘血流量对心功能及炎症反应的影响

目的 探讨老年血液透析病人动静脉内瘘血流量(AVFB)对心功能及炎症反应的影响.方法 选取2017年2月至2018年3月我院利用动静脉内瘘进行血液透析治疗的老年病人124例为研究对象,根据病人动静脉内瘘吻合术后1个月AVFB的流量大小,将病人分为高流量组(>600 mL/min,n=38)、中流量组(400～600 m...

Effects of arterial and venous fistula blood flow on cardiac function and inflammatory reaction in elderly patients with hemodialysis

Objective To explore the effect of arterial and venous fistula blood flow(AVFB)on the cardiac function and inflammatory response in the elderly patients receiving hemodialysis.Methods A total of 124 elderly patients who underwent hemodialysis with arteriovenous fistulas in our hospital from February 2017 to March 2018 were selected as the study subjects.According to the level of AVFB one month after arteriovenous fistula anastomosis,the patients were divided into high-flow group(>600 mL/min,n=38),medium-flow group(400-600 mL/min,n=45)and low-flow group(<400 mL/min,n=41).All the patients received one year maintenance hemodialysis treatment.The cardiac function,inflammatory response and hemodynamic indexes were detected,and the incidence rates of high-risk events and internal fistula dysfunction were recorded and compared among the three groups.Results Before dialysis,there were no significant differences in cardiac function,inflammatory response and hemodynamic indexes among the three groups(P>0.05).After dialysis,with the increase of AVFB,the levels of ejection fraction,cardiac output,cardiac index,left ventricular end-systolic diameter,left ventricular end-diastolic diameter,interleukin-6,tumor necrosis factor-α,C-reactive protein,cardiac output,cardiac stroke volume and central blood volume were increased(P<0.05),but the peripheral vascular resistance was decreased(P<0.05).The incidence of high-risk events in the high-flow group was significantly higher than that in the low-flow group and medium-flow group(P<0.05).The incidence rate of fistula dysfunction in the low-flow group was significantly higher than that in the high-flow group and medium-flow group(P<0.05).Conclusions When the level of AVFB in the elderly patients receiving maintenance hemodialysis is controlled at 400-600 mL/min,the clinical effect is the best.